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Comparable results found for oblique bone tunnels vs. dual suture anchors for patellar fixation
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LYON, France — Results from a retrospective cohort study of 43 knees that underwent medial patellofemoral ligament reconstruction using either oblique bone tunnels or dual suture anchors for patellar instability showed similar clinical outcomes and satisfaction scores for the two techniques.
“Both the tunnel and the suture anchor techniques are effective for MPFL [medial patellofemoral ligament] reconstruction for patella fixation,” David R. Diduch, MD, said during his presentation at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Biennial Congress, here.
Diduch noted the groups were similar prior to the procedure, but that patients who underwent dual, short, oblique bone tunnel fixation had a higher tibial tubercle (TT) to trochlear groove (TG) score (22 vs. 14.8).
“There was a higher rate of associated procedures in the bone tunnel group and, keeping with the higher mean TT-TG in that group, there were more anteromedialization osteotomies in the bone tunnel group, with 79% vs. 11% in the anchor group,” Diduch said.
Patients had a minimum 2-year follow-up. During that time, both groups showed significant improvement postoperatively regarding congruence and patellofemoral angles. In addition, the researchers discovered no significant differences between the groups for VAS score or change in Tegner and Kujala scores.
One failure was reported for each of the groups. In the bone tunnel group, one patient fell and cracked the bone tunnel within 6 weeks of reconstruction and was revised. In the comparison group, one patient had recurrence and elected not to have additional surgery.
Additionally, “There is no difference in return to play or patient satisfaction between the groups,” Diduch said. – by Gina Brockenbrough, MA
Reference:
Diduch DR, et al. Paper #192. Presented at: International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress; June 7-11, 2015; Lyon, France.
Disclosure: Diduch reports that he receives royalties from ArthroCare; is an unpaid consultant for DePuy Mitek; and receives research support from Zimmer, Moximed and Genzyme and financial/material support from DePuy Mitek and Arthrex.